Care Pathways Before and After Initial Diagnosis and Geographical Disparities Among Patients With Obstructive Hypertrophic Cardiomyopathy in France: A Retrospective Claims Analysis
Author(s)
Philippe Charron, Pr1, Jeanne Lacroix, MPH2, Caroline Guilmet, PharmD2, Jules Chassetuillier, MSc3, Cécile Gineste, PharmD, PhD3, Aurélie Schmidt, MSc3, Jean-Noël Trochu, Pr4.
1Sorbonne Université, AP-HP, IHU-ICAN, INSERM 1166, Hôpital Universitaire Pitié-Salpêtrière, Paris, France, 2Bristol-Myers Squibb, Rueil-Malmaison, France, 3HEVA, Lyon, France, 4Institut du Thorax, University Hospital of Nantes, University of Nantes, CNRS,INSERM, Nantes, France.
1Sorbonne Université, AP-HP, IHU-ICAN, INSERM 1166, Hôpital Universitaire Pitié-Salpêtrière, Paris, France, 2Bristol-Myers Squibb, Rueil-Malmaison, France, 3HEVA, Lyon, France, 4Institut du Thorax, University Hospital of Nantes, University of Nantes, CNRS,INSERM, Nantes, France.
OBJECTIVES: This study aims to describe the clinical management of incident patients with obstructive hypertrophic cardiomyopathy (oHCM) before their first hospitalization, at both national and regional levels.
METHODS: An observational retrospective study was conducted using data from the French national claims database (SNDS). Adults with ≥1 oHCM-related hospital stay were included from 2012-2018 and followed until 2019. Only incident patients (i.e., those without any record of HCM at hospital within the 2-year follow-back period) were selected for this analysis. Consultations with primary care and hospital-based cardiologists were extracted and analysed in a two-year period before the index date (corresponding to the first HCM-related hospitalisation) and during follow-up. Geographical disparities of care were assessed according to the 13 administrative regions of France.
RESULTS: Overall, 4,683 oHCM patients were analysed. Most were male (54%), and the mean age was 66.1 years. Mean follow-up duration was 4.6 years. For a majority (78%) of patients, the first oHCM diagnosis at hospital occurred during a stay for another reason. Of the 22% hospitalized specifically for oHCM, the Hauts-de-France region had the highest rate at 29%, and Bretagne had the lowest at 12%. During the two years preceding the index date, 57% of patients had consulted a cardiologist in any setting, varying from 43% in Auvergne-Rhône-Alpes to 68% in Normandie and Provence-Alpes-Côte-d’Azur. In the two years following the index date, this proportion increased to 66%. For hospital-based cardiologists, it increased from 21% before the index date (ranging from 14% in Grand-Est to 29% in Ile-de-France), to 33% after the index date.
CONCLUSIONS: This is the first study describing oHCM patient diagnosis and management by regions in France. Nearly half of the patients were hospitalized with oHCM without previous regular cardiological monitoring, with high regional disparities. These results highlight a need for earlier detection and intervention.
METHODS: An observational retrospective study was conducted using data from the French national claims database (SNDS). Adults with ≥1 oHCM-related hospital stay were included from 2012-2018 and followed until 2019. Only incident patients (i.e., those without any record of HCM at hospital within the 2-year follow-back period) were selected for this analysis. Consultations with primary care and hospital-based cardiologists were extracted and analysed in a two-year period before the index date (corresponding to the first HCM-related hospitalisation) and during follow-up. Geographical disparities of care were assessed according to the 13 administrative regions of France.
RESULTS: Overall, 4,683 oHCM patients were analysed. Most were male (54%), and the mean age was 66.1 years. Mean follow-up duration was 4.6 years. For a majority (78%) of patients, the first oHCM diagnosis at hospital occurred during a stay for another reason. Of the 22% hospitalized specifically for oHCM, the Hauts-de-France region had the highest rate at 29%, and Bretagne had the lowest at 12%. During the two years preceding the index date, 57% of patients had consulted a cardiologist in any setting, varying from 43% in Auvergne-Rhône-Alpes to 68% in Normandie and Provence-Alpes-Côte-d’Azur. In the two years following the index date, this proportion increased to 66%. For hospital-based cardiologists, it increased from 21% before the index date (ranging from 14% in Grand-Est to 29% in Ile-de-France), to 33% after the index date.
CONCLUSIONS: This is the first study describing oHCM patient diagnosis and management by regions in France. Nearly half of the patients were hospitalized with oHCM without previous regular cardiological monitoring, with high regional disparities. These results highlight a need for earlier detection and intervention.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
HSD21
Topic
Epidemiology & Public Health, Health Service Delivery & Process of Care, Real World Data & Information Systems
Disease
Cardiovascular Disorders (including MI, Stroke, Circulatory), No Additional Disease & Conditions/Specialized Treatment Areas